Minimal Contribution of the Social Determinants of Health to the Prevalence of Hypertension among Egyptian Public Servants.

BACKGROUND: Previous research suggests the role of social determinants of health (SDH) in the prevalence of hypertension. OBJECTIVE: The study aimed to estimate the contribution of SDH to the prevalence of hypertension. METHODS: We recruited 3072 Egyptian public servants who answered a self-administered questionnaire, including hypertension history. We measured the participants' blood pressure with standardized procedures. The logistic regression models were used to assess the associations between SDH and hypertension. RESULTS: The prevalence of hypertension was 28.2% (34.2% in males and 22.5% in females). The prevalence of undiagnosed hypertension was 16.3% (23.9% and 9.2%, respectively); thus, 57.8% of the hypertensive subjects were unaware of their high blood pressure status. SDH were associated with the odds of having hypertension in the unadjusted analyses. Higher education, being single, and having minor family members were associated with low odds of hypertension. On the other hand, non-professional occupations, job hours, household income, total family members, and work-family conflicts were associated with higher odds of hypertension. However, in the multivariable analyses, which included all SDH and adjusted for age, gender, smoking, physical activity, body mass index, medical history of chronic diseases, and family history of hypertension, only job hours were associated with the odds of having hypertension and undiagnosed hypertension: odds ratio (95% CI) = 1.07 (1.01-1.14) and 1.11 (1.02-1.20), respectively. CONCLUSION: SDH contributed minimally to the odds of having hypertension among public officials in Minia, Egypt. Civil servants with long working hours should be tracked with regular blood pressure monitoring as a high-risk group for hypertension.

Neurologists' Knowledge, Practice, and Attitudes towards Pharmacovigilance and Adverse Drug Reactions Reporting Process in Epileptic Patients-Comparative Analysis from Poland and Egypt.

OBJECTIVES: To compare neurologists' knowledge, practice, and barriers of pharmacovigilance (PV) process among patients with epilepsy in Poland and Egypt. METHODS: It was an international study that used an online questionnaire e-mailed to neurologists registered to practice in Poland and Egypt. RESULTS: Most of the neurologists were familiar with the definition of PV and adverse drug reactions (ADRs), but relatively few neurologists knew where to report ADRs, especially the Egyptian neurologists. Only 31.11% of the neurologists from Egypt and 39.90% neurologists from Poland declared that they had reported ADRs at least once during their professional practice, and few of them declared the regular reporting of such incidents. The main reason for the neurologists not reporting ADRs was the lack of time and a conviction that reporting ADRs would be an additional burden that would generate extra work. CONCLUSION: The standards of pharmacovigilance process, safety control, and quality are not the same throughout the world. System-regulated PV stabilization in a country translates into the practice of maintaining PV. Monitoring the safety of pharmacotherapy and knowledge of risks associated with ADRs should be included in the academic curricula of physician courses.

Perception and Barriers Regarding Infection Control Measures Among Healthcare Workers in Minia City, Egypt.

BACKGROUND: This study aimed to assess perception of healthcare workers (HCWs) toward infection control measures and to identify the major barriers that may hinder the proper infection control practice and to compare perception of HCWs toward infection control measures between Minia University Hospital and Minia General Hospital. The study was a descriptive cross-sectional study. METHODS: The study conducted on 350 HCWs (187 from Minia University Hospital, 163 from Minia General Hospital); data were collected using a structured questionnaire. The questionnaire was designed to assess perception toward infection control measures and to identify the major barriers that may hinder the proper infection control practice. STATISTICAL ANALYSIS USED: Data were gathered and entered into Statistical Package of Social Science (SPSS), version 22. RESULTS: About 85% of HCWs in Minia University Hospital compared with 82% in Minia General Hospital had a positive perception toward Standard precautions (SPs). Knowledge score was the only significant predictors of perception of HCWs toward infection control. One-point increment in knowledge score is associated with significantly 13% lower odds to have negative perception; the multivariable-adjusted odds ratio (95% confidence intervals) was 0.87 (0.81-0.95). The most frequent barrier of practice of SPs was absence of enough gloves and gowns. CONCLUSIONS: HCWs demonstrated positive perception toward infection control and SPs measures. The most frequent reported barrier against practice of SPs was absence of enough gloves and gowns. The significant predictor that hindered the practice of SPs was that "Following SPs makes work harder."

Determinants of Problematic Internet use and its Association with Disordered Eating Attitudes among Minia University Students.

BACKGROUND: To determine the association between problematic Internet use (PIU) and disordered eating attitudes (DEAs) and to detect the potential risk factors for PIU among University students in Minia, Egypt. METHODS: A cross-sectional study was carried out among a random sample (n = 2365) of Minia University students. PIU was assessed using The Problematic Internet Use Scale (PIUS), and the DEAs were assessed using eating attitudes test-26 questionnaire. RESULTS: Of the 2365 students, 424 (17.9%) had DEAs, and it was more in females than males (22.3% and 14.5%, respectively). The mean of the PIUS score also was significantly higher in males than females (120.3 ± 30.5, and 117.5 ± 30.6, respectively). A positive moderate correlation (r = 0.48, P < 0.05) was detected between PIU and DEAs. CONCLUSIONS: The results of this study indicate that PIU is significantly correlated with DEAs among University students in Minia, Egypt, and further studies are needed to identify the association between DEAs and PIU.

Effects of Mothers' Knowledge and Coping Strategies on the Glycemic Control of Their Diabetic Children in Egypt.

BACKGROUND: This study aimed to examine the relationship between mothers' knowledge related to treatment management of type 1 diabetes (T1D), with perceptions of coping with diabetes-related stress and to examine the relationship between children's metabolic control and maternal coping. A cross-sectional study was done among ninety-two mothers of T1D children. METHODS: Data were collected using a structured questionnaire, Ways of coping questionnaire (WCQ), and Diabetes Knowledge questionnaire-24 (DKQ-24). RESULTS: The most important predictors of the total knowledge scores among mothers were father education (P < 0.0001), followed by child age and sex (P < 0.0001), while the most important coping scales affected by total knowledge scores was accepting responsibility (P = 0.01). There were positive correlation between HBA1C and escape-avoidance and positive reappraisal coping scales (r = 0.24, P = 0.02 and r = 0.23, P = 0.02, respectively). Blood glucose level was the most important clinical characteristics affecting the use of seeking social support coping scale among mothers. CONCLUSIONS: Parents with more knowledge of diabetes and with better education were able to cope more effective and maintain a better glycemic control of their diabetic children.

The Palliative Performance Scale Predicts Survival among Emergency Department Patients, Minia, Egypt.

BACKGROUND: Emergency department (ED) physicians provide care to patients with a wide range of prognoses, and must develop care plans that anticipate patient's survival. However, the tools available to guide care planning had limited data to support their use. There is a new concern to understand if palliative care (PC) should be offered in the ED and the Palliative Performance Scale (PPS), a screening tool used in other settings in PC, has been little used in the ED. AIM: The aim of this study is to assess the prognostic value of the PPS in predicting 1, 3 and 6 months survival in patients admitted through the ED. DESIGN: This was a prospective, cohort study. SUBJECTS AND METHODS: We evaluated 147 patients at the age of 35 years and more admitted through the ED of Minia University hospital from May 1, 2016 to June 31, 2016. Each patient's PPS score was evaluated initially in the ED, with follow-up assessments of survival at 1, 3, and 6 months. RESULTS: Baseline PPS for the 147 patients was 50. The PPS score was a strong predictor of survival (Log-rank test of Kaplan-Meir P < 0.0001). Patients with an initial PPS score of 40 or less were less likely to survive at 6 months. CONCLUSION: The PPS score may predict survival in patients admitted to the hospital through the ED. The ease of use holds promise that the use of the PPS in the ED may help ED physicians predict survival and plan for a better decision.

Linking senile dementia to type 2 diabetes: role of oxidative stress markers, C-reactive protein and tumor necrosis factor-α.

Diabetes is considered an independent risk factor for cognitive impairments. OBJECTIVES: The aim of this study was to evaluate the cognitive disorder of elderly outpatients with and without type 2 diabetes (T2DM) in releationto oxidative stress markers and some inflammatory markers Methodology: Two hundred and twelve participants were classified into four groups according to their fasting blood glucose level, glycosylated hemoglobin (HbA1c) and mini-mental state examination (MMSE) score. Control subjects were 118 subjects, diabetic group without dementia was 54 subjects, diabetic group with dementia was 26 subjects and 14 subjects of dementia without diabetes. Body mass index and waist/hip ratio were measured. Blood glucose, HbA1c, plasma malondialdehyde (MDA), total antioxidant activity (TAC), and some inflammatory markers: C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were measured. RESULTS: Diabetic patients have significant increases in FBG, HbA1c, MDA with a significant decrease in TAC compared to control group. In all groups of patients, the levels of CRP, and TNF-α were significantly higher as compared to control group. The highest level of inflammatory markers was detected in diabetic group with dementia. MMSE score was negatively correlated with HbA1c levels and TNF-α and HbA1c levels were positively correlated with all inflammatory markers. In multivariate logistic regression analysis, MDA,CRP, Hb1c, TNF-a, and FBG were the most predictive risk factors for dementia Conclusions: These results suggest that a decrease in anti-oxidant levels and an increase in anti-inflammatory and oxidative stress markers might be involved in the pathophysiology of cognitive disorder associated with T2DM.

Home unintentional non-fatal injury among children under 5 years of age in a rural area, El Minia Governorate, Egypt.

Injury is the leading cause of morbidity and mortality in children aged 1-14 years, with home injuries a particular problem in the preschool-age group. The focus of this study was to determine the frequency, and the outcome of unintentional non-fatal injuries among children under 5 years of age in the household, and to describe the related risk factors through a community-based survey. A cross-sectional community based study was conducted on a random sample of 1,255 rural Egyptian children under 5 years of age. Data were collected by a questionnaire which included; socio-demographic data, history, type, and the outcome of unintentional home injuries in the previous year. Of 1,255 children, 55.9 % were males and 44.1 % were females, and their mean age was 28.6 ± 11.8 months. The frequency of unintentional non-fatal home-related injuries was 20.6 %. Injury rates were the highest among children during the third year of life, those of less educated parents, those whom mothers are of young age, and those with low household socioeconomic standard. Homes of injured children were not significantly different from the homes of non-injured children. Burns were the most common injuries among all the study groups (38 %) followed by falls (35.3 %). 'Handicaps' were more strongly associated with falls and burns (6.6 and 4.1 % respectively). Unintentional injuries are common among children under 5 years of age in rural Egypt. Therefore, measures should be taken to prevent children from the most frequently recorded home injuries such as burns and falls.

Determinants of problematic internet use among el-minia high school students, egypt.

BACKGROUND: Problematic Internet Use (PIU) is a growing problem in Egyptian adolescents. This study was designed to assess the prevalence of PIU among high school students in El-Minia Governorate and to determine the personal, clinical, and social characteristics of them. METHODS: A cross-sectional study was applied among a random sample of high school students in El-Minia Governorate. PIU was assessed by the 20-item Young Internet Addiction Test (YIAT). Information was also collected on demographics, dietary, and health-related factors. STATISTICAL ANALYSIS USED: Statistical Package for Social Sciences (SPSS-16) software was used. Chi-square test (X (2)), Fisher's Exact Test, and one-way analysis of variance (ANOVA) were used whenever, applicable. Multinomial logistic regression analyses were also applied in order to calculate the odds ratios (OR). RESULTS: Of the 605 students, 16 (2.6%) were Problematic Internet Users (PIUs), 110 (18.2%) were Potential (PIUs). Adolescents with PIU were associated with male gender, poor friends' relations, bad family relations, irregular bedtime, and bad personal hygiene. PIUs were more likely to suffer from physical symptoms; weight gain, joint stiffness, lack of physical energy, and emotional symptoms. CONCLUSIONS: The prevalence of PIU reported in this study is low, however, the Potential PIUs was high and preventative measures are recommended.

The effects of exercise on C-reactive protein, insulin, leptin and some cardiometabolic risk factors in Egyptian children with or without metabolic syndrome.

BACKGROUND: The prevalence and magnitude of obesity in the children and the adolescents have increased dramatically in the developing countries over the last 20-30 years. The prevalence of metabolic syndrome (MS) in children is increasing. AIM: This study aimed to investigate the changes of C-reactive protein (CRP), leptin, insulin, and blood lipids before and after the exercise therapy in normal and obese children (with or without metabolic syndrome). METHODS: The study covered 49 normal children (control), 32 obese children without metabolic syndrome and 12 obese children with metabolic syndrome. We examined the influence of exercise (3 times/week) for 12 weeks on the levels of serum CRP, leptin, insulin, homeostatic model assessment insulin resistance (HOMA-IR), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in all groups. RESULTS: There were significant correlations between HOMA-IR and the individual components of the metabolic syndrome. After 12 weeks of exercise, both of the obese children groups, with and without metabolic syndrome, showed reduced body weight, body mass index (BMI), and CRP level, and increased HDL-C level. The percentage of metabolic syndrome decreased from 12.9% before the exercise training to 7.5% after training. Also, there was a significant reduction in BMI (from 47.3 to 32.6%), in systolic blood pressure (from 18.3 to 15.1%) and in HDL-C level (from 18.3 to 9.7%). CONCLUSION: Overweight children have multiple risk factors associated with the metabolic syndrome. 12-week exercise may have a positive effect on reducing risk factors for the metabolic syndrome.

Factors affecting survival of women diagnosed with breast cancer in El-Minia Governorate, Egypt.

OBJECTIVES: This study was conducted to determine breast cancer survival time and the association between breast cancer survival and socio-demographic and pathologic factors among women, in El-Minia, Egypt. While there has been much researches regarding prognostic factors for breast cancer but the majority of these studies were from developed countries. El-Minia has a population of approximately 4 million. To date, no research has been performed to determine breast cancer survival and the factors affecting it in El-minia. METHODS: This retrospective study used data obtained from the cancer registry in the National Institute of Oncology in El-Minia and included 1207 women diagnosed with first primary breast cancer between 1(st) January 2005 and 31(st) December 2009 and followed to 30(th) June 2010. The association between survival and sociodemographic and pathological factors and distant metastasis at diagnosis, and treatment options was investigated using unifactorial chi-square test and multi-factorial (Cox regression) analyses. Kaplan-Meier analysis was used to compare survival time among different groups. RESULTS: Median survival time was 83.8 ± 3.2. Cox regression showed that high vs low educational level (Hazard ratio (HR)= 0.35, 95% CI; 0.27-0.46), metastases to bone (HR = 3.22, 95% CI: 1.71-6.05), metastases to lung (HR= 2.314, 95% CI: 1.225-4.373), tumor size (≤ 2 cm vs ≥ 5 cm: HR = 1.4, 95% CI: 1.1-1.8) and number of involved nodes (1 vs > 10 HR = 5.21, 95%CI: 3.1-9.01) were significantly related to survival. CONCLUSIONS: The results showed the need to develop screening programs and standardized treatment regimens in a tax-funded health care system.

Stature and body weight estimation from various footprint measurements among Egyptian population.

Analysis of footprints can reveal very important clues which can be used as a forensic evidence and help in the estimation of stature and body weight of an individual. In this work, bilateral footprints were obtained from 50 male Egyptian medical students ranging in age between 18 and 25. Nine measurements were taken on each footprint. The result revealed significant bilateral asymmetry (p < 0.001) except foot breadth at ball. The significant and positive highest correlation coefficients with stature were shown by toe-5 length on right side (R = 0.58) and with body weight by foot breadth at ball on left side (R = -0.52). Regression equations presented smaller standard errors of estimate (3.52-4.69) in determination of stature than those in estimation of body weight (4.05-5.28). In conclusion, this study has provided equations that help to estimate stature and body weight from footprint measurements among Egyptians.

Stature estimation from hand and phalanges lengths of Egyptians.

Estimation of stature from extremities plays an important role in identifying the deceased in forensic examinations. This study examines the relationship between stature and hand and phalanges lengths among Egyptians. Stature, hand and phalanges lengths of 159 subjects, 82 males and 77 females (18-25years) were measured. Statistical analysis indicated that bilateral variation was insignificant for all measurements. Sex differences were significant for all measurements. Linear and multiple regression equations for stature estimation were calculated. Correlation coefficients were found to be positive, but little finger measurements of male and distal phalanges of female fingers were not correlated with stature. Regression equations were checked for accuracy by comparing the estimated stature and actual stature.